Inspection on 12/01/06 for Bedford Road 7

This inspection was carried out on 12th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bedford Road 7 11/11/08

Bedford Road 7 10/06/08

Bedford Road 7 16/07/07

Bedford Road 7 19/05/06

Bedford Road 7 29/11/05

Bedford Road 7 13/09/04

Bedford Road 7 26/04/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Bedford Road 7 London N15 4HA Lead Inspector Mr Teferi Degeneh Unannounced Inspection 12th January 2006 10:10 Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bedford Road 7 Address London N15 4HA Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8800 2864 020 8800 2864 bedfordrhailltdtinternet.com HAIL (Haringey Association for Independent Living Limited) Mr John Philip Parsonage Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Limited to 6 people of either gender who have a learning disability (LD) and who may also have a physical disability (PD) 29th November 2005 Date of last inspection Brief Description of the Service: Bedford Road is a home registered to provide residential care to six people who may have learning disability or physical disability. The building is provided by Circle 33 Housing Association and the services are provided by Haringey Association for Independent Living (HAIL). The home is located in a residential area close to the Seven Sisters Underground and shopping facilities. There are six single bedrooms, three bathrooms/showers and three toilets. There are a lounge, a kitchen, a dining room and a large garden at the rear of the building. The ground floor of the home is wheelchair accessible even though the current service users do not require this. The home has stated objectives of enabling service users to live as independently as possible, with the same range of choices as any other citizen, mixing as equals with others and being members of their own community. Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken over a period of six hours commencing approximately at 10:10 am and concluding at just after 4 Pm. Mr Fred Brown, a care worker, was present thoroughwort to assist with the inspection. Three other care staff were also spoken to at different times during the inspection. Two of the people, who were at the home, were observed and spoken to. A pre-inspection questionnaire completed by the registered person and sent to the Commission for Social Care Inspection, and feedback cards completed by relatives of the people who live at the home were considered as part of this inspection. The premises were checked during the guided tour of the premises. The home’s policies, procedures and records including the service users’ files were examined. However, the staff files were not seen at this inspection as the keys to the filing cabinet were kept by the deputy managers, who were not on shift on the day of the inspection. What the service does well: What has improved since the last inspection? What they could do better: The timescale for one of the requirements made at the last inspection is yet to be reached and this has been restated in this report. The timescale for action for this requirement has not been changed, as it is sufficient for the registered person to employ a manager who would make an application for registration by the Commission for Social Inspection. Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 6 Three new requirements are made at this inspection. There are all related to health and safety and the registered person must take actions. It is required that hand drying facilities are available in the toilets and that the temperature of the hot water in the bathroom on the first floor and the toilets is regulated. The faulty gas boiler must be repaired and alternative arrangements must be in place to ensure continuity of adequate heating systems in all the rooms used by service users and staff. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, and 2 The statement of purpose is updated and a new certificate of registration obtained and displayed. Satisfactory admission procedures are in place and service users can be confident that they are admitted to the home on the basis of the outcome of their needs assessment and on the basis of the ability of the home to meet their needs. EVIDENCE: The registered person is currently completing the statement of purpose. The draft form of the statement of purpose, which was seen, was up to date and contained information about the services, facilities and the staff. The responsible person said all the staff have seen the draft copy of the statement of purpose and the final version will be available soon. At the last inspection the registered person was required to replace the certificate of registration so that it reflects the realities in the home. This has been complied with and a new certificate of registration is prominently displayed at the home. No new service users have been admitted since the last inspection. The home has an admission’s procedure and service users are admitted on the basis of the outcome of their assessments and the ability of the home to meet their needs. The assessments are completed by their social workers and by the home. Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9 The procedures for care plans and assessments are satisfactory and service users can be confident that they are involved in their needs assessments and they receive care that meet their needs. EVIDENCE: Care plans have been reviewed for all service users. Each key worker writes a summary of significant events and activities of service users every month. Service user files, which were assessed, contained evidence of the involvement of families and professionals in annual review meetings. The staff are proactive in taking notes of reviews and keeping them in files for reference while waiting for the minutes from social workers. It was evident from the files that risk assessments have been developed and reviewed for all service users. The assessments provide information in relation to possible risks to service users and actions that need to be taken to eliminate or minimize the risks. Discussions with the responsible person and an examination of service user files indicated that outside professionals have been requested to help with undertaking of a risk assessment for a service user. The people who live at the home were observed to be relaxed both while staying by themselves in the lounge and while interacting with staff in the kitchen/dining area. Two service users spoken to said they are happy with the staff and facilities. During the Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 10 tour of the premises it was noted that the hot water in a bathroom and in some toilets was extremely hot and could put people at risk. An immediate requirement was issued about this and this is mentioned again below in the appropriate section. Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, and 17 The home has a good working relationship with social and leisure activity providers to ensure that service users are engaged. The procedure for keeping and controlling service users’ finances has improved and encouraging progress has been made to open individual bank/post office accounts for each service user. The food provided at the home is good and service users’ are consulted and their needs met. There are good arrangements and support for service users to visit families and friends, and to go on suitable holidays. EVIDENCE: At the last inspection a requirement was made for the registered person to support the people who live at the home with management of their finances. It was noted from records and discussions with the responsible person that service users’ finances are paid into the Company’s account and records are kept regarding the amount of money each person has. It was evident from records and discussion with the responsible person that the home has begun a process of setting up accounts for individual service users. Currently, there are to safes at the home. The key to the main key is kept by the assistant managers and the key to the second safe, where personal allowances are kept, Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 12 are held by staff who are rostered to do late, sleep-in and early shifts. Money in the safes are daily checked during handover times. All the service users have a day activity. At the time of the inspection four service users were out attending their day activities. One service user was at the home because it was a day when they visit their family. A programme of activity was displayed in the dining room. The service users files contain details of service users’ activities. Records showed that a service user’s artwork was chosen to be par of last year’s Christmas card, printed and distributed by a local charity. Three families who completed comment cards stated that communication between themselves and the home has greatly improved since the appointment of a new manager. It is to be noted that the manager referred to has resigned and the home has currently no manager. However, from records it is clear staff communicate with families and often support service users to visit their families and friends. There home has a five weekly rotating menu. The menus are user-friendly with pictorial illustrations. Meals are prepared by the staff who have attended basic food hygiene training. The service users spoken to confirmed that they are happy with the meals provided at the home. At the time of the visit there were sufficient food items and fruits in the home. It was confirmed through discussions with the staff that the home does food shopping twice a week. Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20 The policies, procedures and practices of medication administration are satisfactory. These have ensured the health and safety of service users. The home has worked hard to arrange a needs assessment review meeting and provide appropriate care for a service user whose needs have recently changed. There are satisfactory procedures to ensure that the health needs of service users are met. EVIDENCE: It is stated above that service users’ needs are assessed and that service plans are developed and updated regularly. At the last inspection a requirement was made regarding a service user whose needs have significantly changed to be satisfactorily meet by the facilities and the staff at the home. Evidence was available that the service user’s needs are assessed by a social worker and the representatives of the service user have been consulted. From discussions with the staff and from records it was clear that progress was made by the home to identify the service user’s new needs and provide appropriate service. The responsible person stated that the home and the placing authorities have agreed to provide an additional care staff to ensure that the service user would be cared for on a one-to-one basis. All the service users are registered with their general practitioners and had appointments with dentists, opticians and chiropodists. From the pre-inspection questionnaire it is evident that service Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 14 users pay £12.00 to see a chiropodist. In group and individual discussions the staff gave satisfactory description of how they support service users with personal care by taking gender into account and by ensuring privacy, dignity and choice of service users. The staff administer medication and it was evident that the staff have received relevant training. The medication administration record sheets and the medicines were checked and were in order. Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, and 23 The home has satisfactory adult protection and complaints procedures. Service users can be confident that their concerns can be taken seriously and dealt with by the home. EVIDENCE: No complaints have been recorded since the last inspection. The complaints procedure has been updated to include the address of the local CSCI office. The complaints procedure is written with pictorial illustrations for use by nonverbal service users. A copy of the procedure is included in the service users’ guide and the statement of purpose. At the last inspection certificates were seen in staff files to indicate that the staff have attended training on adult protection. The staff spoken to were confident of their knowledge of how to protect vulnerable people and how to deal with abuse. The staff confirmed that they have read the home’s policies including the whistle blowing policy. There is a copy of the placing authority’s adult protection policy and procedure. Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, and 30 Even though the premises are spacious, airy, bright and free from offensive odours, there are health and safety issues in the home, which put service users at risk. This is evidenced by the lack of hand drying facilities near wash hand basins and by the high temperature of the hot water in the bathroom and in the toilet rooms. EVIDENCE: Appropriate adaptations are provided in the bathrooms and in the toilets. There are handrails in the stairs and the corridors and landings are wide. The home is bright, the windows have restrictors, and the radiators are guarded. Some of the carpets in the corridors/landing seem to be unclean despite the claim by the staff that the rooms are vacuum cleaned daily. There was no offensive smell and the home was bright. The home is located in a residential area close to local shops and public transport facilities. The Seven Sisters Underground Station (Victoria Line) is within walking distance from the home. The home has a policy on infection control. The staff use gloves when moving clothes to the laundry room. It was noted during a guided tour of the premises that hand drying facilities were not provided in areas where there are wash hand basins. It was also noticed that the temperature of hot water in the bathroom on the first floor and in the toilets was too hot. The responsible person checked the hot water with the inspector and agreed that the Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 17 temperature of the water was too hot and risky for service users to use. An immediate requirement was issued regarding the temperature of the hot water. Another issue observed during the tour of the premises was the faulty boiler. A requirement regarding this is made below. Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, and 35 The staffing level, the recruitment procedures and staff training opportunities available at this home are satisfactory. These ensure that service users are supported by adequate number of who are adequately vetted in terms of their suitability to care for them. EVIDENCE: There are ten care staff employed at the home. The rota shows that a minimum of three care staff are on duty during early and late shifts. A sleeping-in staff member and a waking night worker cover night duties. The number of staff on shift on the day of the inspection was in line with what was written in the rota. The registered person confirmed in a pre-inspection questionnaire that the staff have attended a range of training programmes including infection control, basic food hygiene, health and safety, adult protection, fire safety, and moving and handling. The home has a training plan for staff in areas such as person centre plan, incontinence, and risk and needs assessment. Eight of the care staff have embarked on care training to achieve NVQ qualifications. At this inspection the staff files were not assessed. However, as part of an action plan for the last requirement, the registered person has confirmed in writing stating that no staff, whether fulltime, bank and agency staff start work at the home unless they have clear CRB’s. It was confirmed by the responsible person that no new staff have been employed since the last inspection. Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, and 42 The registered person has made good effort in terms of advertising for the vacant post of the manager of the home. The deputy managers are capable, determined and experienced to run the home. However, service users lack of a registered manager has a negative impact on the way the home is run. The arrangements for repairing faulty equipment such as the gas boiler are satisfactory putting service users at a great risk. EVIDENCE: At the last inspection a requirement was made for the registered person to ensure that a manager is appointed to run the home and that an application for registration is submitted to the CSCI by this individual. An action plan produced as a result of this requirement and a discussion with the responsible person showed that the process of recruitment of a manager has begun and a person has been interviewed. Meanwhile, two deputy managers, who are supported by the Service Manager, continue to manage the home. The Service Manager visits and undertakes inspection of the home once every month as required by Regulation 26 (Care Home Regulations 2001). Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 20 It has been mentioned under different sections in this report that risk assessments and care plans have been completed for service users. There are adaptations in the bathrooms and in the toilets. Handrails are provided in the stairs and the corridors and landings are wide. The home is bright, the windows have restrictors, and the radiators are guarded. The staff have attended training on health and safety, first aid, fire, basic food hygiene, and medication administration. One incident/accident has been recorded since the last inspection. Records showed that fire drills take place and fire extinguishers and fire alarms tested and serviced regularly. It was evident from documents that all the portable electrical appliances were tested on 16/11/05. The last requirements in relation to the recommendations by an Environmental Health Officer and by the fire safety officers have been complied with. It was stated above that the hot water in the bathroom on the first floor and in some toilets was very hot. It was also mentioned that the gas boiler was faulty and the heating to rooms, including bedrooms was available intermittently. An immediate requirement was issued regarding these. Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bedford Road 7 Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 2 X X X X 2 X DS0000010716.V265569.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA24 Regulation 13; 23 Requirement It is required that the temperature of the hot water in bathrooms and in toilet rooms is regulated and appropriate risk assessment is undertaken to prevent possible incidents such as scalding. The registered person must provide hand drying facilities in toilet rooms. The registered person must ensure that a manager is appointed to run the home and that an application for registration is submitted to the CSCI by this individual. (Timescale of 25/02/06 not reached.) The registered person must ensure that the gas boiler is repaired and is in good working order. Service users must be provided with an adequate heating system that meets their needs. Timescale for action 18/01/06 2 3 YA30 YA37 13(3) 9(1)(2) 15/02/06 25/02/06 4 YA42 13; 23 12/01/06 Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA30 Good Practice Recommendations The registered person should replace the carpets. Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bedford Road 7 DS0000010716.V265569.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!